DR. KATHERINE R. PETERSEN D.M.D.
NPI 1992996946
Dentist in Charlotte, NC

Q: What is Katherine Petersen's NPI number?

The NPI number for Katherine Petersen is 1992996946. It was assigned to this individual provider in the NPPES registry on August 6, 2007. The provider is also known as Dr. Katherine E. Rhyne D.M.D..

Q: What is Katherine Petersen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Katherine Petersen enrolled in Medicare?

No. Katherine Petersen has opted out of Medicare through January 6, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since August 06, 2007Opted out of Medicare · through Jan 6, 2028

10230 BERKELEY PLACE DR STE 200, CHARLOTTE, NC 28262(704) 688-7588 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 2, 2021, Aug 22, 2019, Apr 11, 2017 and 2 more (5 updates tracked since 2016).

On this page

About Dr. Katherine R. Petersen D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KATHERINE R. PETERSEN D.M.D. (NPI 1992996946) is an individual dentist in Charlotte, North Carolina, licensed in North Carolina (10553) and active in the NPI registry since August 2007. She has opted out of Medicare through January 6, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1992996946

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. KATHERINE R. PETERSENCredential: D.M.D.

Location Address10230 BERKELEY PLACE DR STE 200Charlotte, NC 28262-1203

Mailing Address133 Creek Side DrMount Holly, NC 28120-9247 · (704) 577-2798

Phone(704) 688-7588

Sole ProprietorNo

Enumeration DateAugust 6, 2007

Last NPPES UpdateMarch 2, 20215 updates tracked since enumeration

NPPES CertifiedFebruary 2, 2021

✔ NPI 1992996946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in NC · 10553

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

10230 BERKELEY PLACE DR STE 200, Charlotte, NC 28262

Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Katherine E. Rhyne D.m.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Katherine R. Petersen D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 6, 2016 through January 6, 2028.

Opt-Out Effective DateJanuary 6, 2016

Opt-Out In Effect ThroughJanuary 6, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28262 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STELLA O NNADI DMD PA

Clinic/Center (Dental)

10230 BERKELEY PLACE DR STE 200
CHARLOTTE, NC 28262

Mecklenburg County (704) 688-7588

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katherine Petersen's NPI number?

The NPI number for Katherine Petersen is 1992996946. It was assigned to this individual provider in the NPPES registry on August 6, 2007. The provider is also known as Dr. Katherine E. Rhyne D.M.D..

Where is Katherine Petersen located?

Katherine Petersen practices at 10230 Berkeley Place Dr Ste 200, Charlotte, NC 28262. The listed phone number is (704) 688-7588.

What is Katherine Petersen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Katherine Petersen enrolled in Medicare?

No. Katherine Petersen has opted out of Medicare through January 6, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Katherine Petersen accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Guardian and 2 other insurers list Katherine Petersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Katherine Petersen was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.